BACKGROUND: Treatment rates for hepatitis C virus (HCV) have not been compared directly between HCV mono-infected and HCV-HIV co-infected patients in academic center settings. METHODS: We prospectively enrolled consecutive mono-infected and co-infected subjects at three academic centers in the USA. Clinical and laboratory data were gathered through interviews and medical records. Logistic regression analysis was used to determine the factors associated with treatment prescription for HCV. RESULTS: The 241 HCV mono-infected and 158 HCV-HIV co-infected subjects were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the latter group. The co-infected subjects were less likely to have a liver biopsy (43.7% vs. 71.4%, p < 0.001) or ever receive treatment for HCV (32.3% vs. 62.2%, p < 0.001). In bivariate analysis, subjects not prescribed treatment for HCV were more likely to be black, have HIV co-infection, and have ongoing alcohol abuse. In multivariate analysis, black race (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.28-0.70) and HIV co-infection (OR 0.33, 95% CI 0.21-0.53) were independently associated with non-prescription of treatment. CONCLUSIONS: Black race and HIV co-infection are associated with a lower likelihood of treatment for HCV. Addressing comorbidities in these populations may help to reduce such treatment disparities.
BACKGROUND: Treatment rates for hepatitis C virus (HCV) have not been compared directly between HCV mono-infected and HCV-HIV co-infectedpatients in academic center settings. METHODS: We prospectively enrolled consecutive mono-infected and co-infected subjects at three academic centers in the USA. Clinical and laboratory data were gathered through interviews and medical records. Logistic regression analysis was used to determine the factors associated with treatment prescription for HCV. RESULTS: The 241 HCV mono-infected and 158 HCV-HIV co-infected subjects were similar in age, but there were more blacks (58.9% vs. 30.7%, p < 0.001) and males (81.6% vs. 58.5%, p < 0.001) in the latter group. The co-infected subjects were less likely to have a liver biopsy (43.7% vs. 71.4%, p < 0.001) or ever receive treatment for HCV (32.3% vs. 62.2%, p < 0.001). In bivariate analysis, subjects not prescribed treatment for HCV were more likely to be black, have HIV co-infection, and have ongoing alcohol abuse. In multivariate analysis, black race (odds ratio (OR) 0.44, 95% confidence interval (CI) 0.28-0.70) and HIV co-infection (OR 0.33, 95% CI 0.21-0.53) were independently associated with non-prescription of treatment. CONCLUSIONS: Black race and HIV co-infection are associated with a lower likelihood of treatment for HCV. Addressing comorbidities in these populations may help to reduce such treatment disparities.
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Authors: Raymond T Chung; Janet Andersen; Paul Volberding; Gregory K Robbins; Tun Liu; Kenneth E Sherman; Marion G Peters; Margaret J Koziel; Atul K Bhan; Beverly Alston; Dodi Colquhoun; Tom Nevin; George Harb; Charles van der Horst Journal: N Engl J Med Date: 2004-07-29 Impact factor: 91.245
Authors: Stephanos J Hadziyannis; Hoel Sette; Timothy R Morgan; Vijayan Balan; Moises Diago; Patrick Marcellin; Giuliano Ramadori; Henry Bodenheimer; David Bernstein; Mario Rizzetto; Stefan Zeuzem; Paul J Pockros; Amy Lin; Andrew M Ackrill Journal: Ann Intern Med Date: 2004-03-02 Impact factor: 25.391